CMS Formulary

Displaying 53791-53800 of 1611142 results.
ID: 53791
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53792
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53793
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53794
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53795
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53796
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53797
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53798
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53799
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53800
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106997
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0